Intravenous infusion is a very strict and specialized technical operation that uses the principles of atmospheric pressure and fluid hydrostatic pressure to deliver drugs into the body from a vein. The drip rate must be determined according to various factors such as the patient’s age, condition, nature of the drug, total amount of infusion and the purpose of the infusion. Normal drip rate Generally, the infusion rate is 40-60 drops/minute for adults, 20-40 drops/minute for children, and should not exceed 40 drops/minute for the elderly. What is the appropriate slow drip rate. Vancomycin, potassium-containing drugs, blood pressure-raising drugs and carbapenems should be given slowly, such as sodium nitroprusside, which can cause a sharp drop in blood pressure if given too quickly. Nitroglycerin and isosorbide mononitrate should be administered at a rate of 8-15 drops/minute; too fast may cause a drop in blood pressure, an increase in heart rate, or even fainting. Potassium drip speed is too fast or cause hyperkalemia, manifested as weakness of limbs, numbness of hands, feet, mouth and lips, dyspnea, slowed heart rate, heart rhythm disturbance, and even cardiac arrest; some special patients, such as those with heart disease (especially cardiac insufficiency) or lung disease, the infusion speed should be controlled at 30-40 drops/min; too fast infusion of amino acids, fatty milk and other parenteral nutrition drugs can cause red face, fever, nausea, vomiting, palpitations, chest tightness and other discomforts. Infusion into saline should not be too fast, because in saline, only the solubility of sodium is similar to that of plasma, while the chloride content is much higher than the plasma concentration (chloride concentration of saline is 154 milli-equivalents/liter, while the chloride concentration of plasma is only 103 milli-equivalents/liter), and the result of too fast infusion can make the chloride ion in the body increase rapidly. Slow drip is recommended for children, elderly people and patients with poor cardiac and renal function, otherwise the cardiac load can be increased by the large amount of fluid input in a short period of time. Due to rapid intravenous infusion, the blood volume increases suddenly and the cardiopulmonary load is excessive, which can lead to heart failure and pulmonary edema in serious cases. This situation is especially common in patients with pre-existing cardiopulmonary disorders or elderly patients. What are the common clinical conditions that should be dripped quickly: when treating bleeding and increased intracranial pressure, for example, 20% mannitol 250ml is generally required to be dripped within 30 minutes, otherwise the effect of lowering cranial pressure will not be achieved. In patients with severe dehydration caused by diarrhea, vomiting, bleeding, burns, etc., if the cardiopulmonary function is good, the remedy should generally be carried out at a rate of about 10 ml per minute, and the total daily infusion should be completed in 6-8h so that the patient can rest after the infusion is completed. For patients in shock with severe volume deficiency, the infusion rate within 1-2h from the beginning of resuscitation should be more than 15ml per minute. Since, if 2000ml of fluid infusion in 2h can make a patient in shock improve quickly, if the slow infusion rate, so that 2000ml of fluid in 24h slowly drip into, it will not help the shock. Acute renal failure for palpable remedy, often given 10% glucose solution 500ml, at a rate of 15-25ml per minute infusion into. Therefore, when fast infusion of more than 10ml per minute is achieved, the nursing staff should be sure of the number of breaths and pulse rate before the infusion, if after the infusion, the number of breaths and pulse rate is faster than before and accompanied by frequent coughing, the drip rate should be slowed down and the doctor should be notified immediately for examination. In addition to maintaining one speed at all times, the drip rate should be adjusted at any time according to actual needs; for example, rehydrated patients should be rehydrated faster and then slower. Calculation of infusion time and infusion rate The number of drops per milliliter (drops/ml) is the drop coefficient. For example, if the total amount of liquid input is 2000ml per day and it takes 10h to finish the infusion, find the number of drops per minute. Ans: The number of drops per minute = 2000 × 15 ÷ (10 × 60) = 30,000/600 = 50 (drops). Infusion time (minutes) = total amount of liquid (ml) × drop factor (drops/ml) ÷ number of drops per minute (drops/minute) For example: a patient needs to infuse 1500 ml of liquid, the number of drops per minute is 50, and the drop factor of the infuser used is 20, how long does it take to finish the infusion? Ans: Time (hours) = (1500 × 20) ÷ 50 = 10 hours Total amount of infusion (ml) = infusion time × number of drops per minute (drops/minute) ÷ drop factor (drops/ml) Example: A patient needs infusion for 2 hours, the number of drops per minute is 50, and the drop factor of the infuser used is 20, what is the total amount of infusion? Ans: Total infusion volume (ml) = 2×60×50÷20=300 ml Detailed list of commonly used drugs with infusion speed requirements 1. 250 ml of mannitol drip rate less than 30 minutes (>170 drops/min) 2. Edaravone drip rate within 30 minutes (>70 drops/min) (saline 100 ml) 3. Fibrinolytic enzyme drip rate 45-50 drops per minute on the first day, and later Regular speed (saline 250ml) 4.Guipizide drip speed 100ml per hour (<30 drops/min) 5.Vincristine drip speed <80 drops/min, 500ml of prepared liquid for 3 hours 6.Potassium chloride drip speed according to the condition and medical advice 7.Pantoprazole drip speed within 15-60 minutes (30-100 drops/min) 8.Calf blood drip speed (per minute/minute) should not be mixed with other drugs 9.Levofloxacin drip speed 60-90 minutes, must not be mixed with other drugs (<33 drops/minute) 2ml (30-50d) 10.Xiyanping drip speed 30-60 drops per minute, strictly prohibited to mix with other drugs 11.Prostil and infusion mixed within 2 hours 12.Moxifloxacin must not be mixed with other drugs 13.Danhong Not to be mixed with other drugs 14.Safflower not to be mixed with other drugs 15.Ambroxol is prohibited to be mixed with other drugs, especially avoid cephalosporin antibiotics, Chinese medicine injections with contraindications 16.Sparing agent not to be mixed with other drugs 17.Reduced glutathione drip rate 1-2 hours 18.Ganciclovir drip rate not to be less than 1 hour 19.Myostatin drip rate 2ml per minute, ( 20.Cefoperazone drip rate not less than 30 minutes 21.Cefepime 50-100ml about 30 minutes drip 22.Moxifloxacin 250ml, need to flush the tube, about 90 minutes drip What conditions should be fast speed drip Clinical common drip rate should be fast conditions: and treatment of bleeding, intracranial pressure increased disease, for example, 20% mannitol 250ml generally It is required to finish the drip within 30 minutes, otherwise the effect of lowering the cranial pressure will not be achieved. In patients with severe dehydration caused by diarrhea, vomiting, bleeding, burns, etc., if the cardiopulmonary function is good, the remedy should generally be carried out at a rate of about 10 ml per minute, and the total daily infusion should be completed in 6-8 h, so that the patient can rest after the infusion is completed. For patients in shock with severe volume deficiency, the infusion rate within 1-2h from the beginning of resuscitation should be more than 15ml per minute. Since, if 2000ml of fluid infusion in 2h can make a patient in shock improve quickly, if the slow infusion rate, so that 2000ml of fluid in 24h slowly drip into, it will not help the shock. Acute renal failure for palpable remedy, often given 10% glucose solution 500ml, at a rate of 15-25ml per minute infusion into. The needle should be thick and firmly fixed during the rapid static drip, and the condition should be observed. Therefore, when the rapid infusion of more than 10 ml per minute is reached, the nursing staff should accurately grasp the number of breaths and pulse rate before the infusion, and if the number of breaths and pulse rate are faster than before after the infusion and accompanied by frequent coughing, the drip rate should be slowed down and the doctor should be notified immediately for examination.